Due to the tumor location, or other potential complications, a thoracoscopy may not be possible. Alternative biopsy procedures used for diagnosis involve thoracentesis or draining of fluid buildup. Needle biopsy’s remove a sample of cells through a needle. Surgery to remove a tumor.
Draining Fluid Build-up
Thoracentesis is a procedure in which a hollow needle or cannula is used to remove fluid from the pleural space around the lungs.
This procedure removes fluid build-up which can causes pain, shortness of breath and decreased lung function. Once the fluid is removed it may be analyzed diagnostically.
Thoracentesis can remove cancerous fluid build-up as well. Pleurodesis may be preformed at the same time as thoracentesis.
Paracentesis is a procedure in which fluid is removed from the abdominal lining. Pericardiocentesis, similarly, is a procedure in which fluid is extracted from the sac around the heart.
FNA (Fine-needle aspiration) is a preferred biopsy method for areas difficult to reach, e.g. the lymph nodes located between the lungs. This, minimally invasive, method uses a long, hollow needle attached to a syringe. The procedure can remove a sample of up to 10,000 cells. This is may be done as an outpatient procedure without the need for general anesthesia.
Core needle biopsies are performed when the tumor is easily accessible. Ultrasound imaging is often used to guide the biopsy which is collected using a wider needle. This procedure is usually done with local anesthesia.
Overall diagnostic sensitivity, even with larger samples, is around 80 percent for diagnosing mesothelioma with needle biopsies. Therefore, needle biopsies are not as effective for diagnosing as thoracoscopic.
Tumor Removing Surgery
The attempt by surgeons to remove as much of the malignant mesothelioma cancer as possible is a surgical resection procedure. The method allows for the most tissue analysis and often reduces the need for a second surgery if testing indicates the tumor is malignant.
A laparotomy refers to a surgical incision of the abdomen. Thoracotomy involves surgery of the chest.